Early diagnosis of diabetes and effective monitoring of its progression could help prevent the development of chronic kidney disease. Towards this goal, European scientists developed a simple urine test. Diabetes constitutes a major risk factor for irreversible kidney malfunction. Currently, there is no therapy for diabetic nephropathy, just treatment to delay disease progression.
However, in cases of terminal disease when kidney dialysis fails, organ transplantation is the only solution. Additional causes of end-stage kidney disease include immunologic, inflammatory and hereditary causes as well as chronic hypertension.
To diagnose kidney damage early enough, save lives and eliminate suffering, non-invasive tools are needed. With this in mind, the EU-funded UROSENSE (Biomarker applications for nanotechnology and imaging in diabetes) project combined leading edge diabetes research with high-profile protein research to identify and validate novel biomarkers. The idea was to utilise these biomarkers in a non-invasive urine test to monitor kidney function and diabetes progression.
Urinary exosomes (nanometer-sized vesicles) reflect the proteome of all the epithelial cells lining the urinary pathway and the drainage system. Scientists focused on the identification of biomarkers in exosomes that are present in all bodily fluids to obtain diagnostic information.
The consortium developed and optimised robust isolation protocols of exosomes from urine and techniques for sub-fractionating vesicles. Using hydrostatic filtration dialysis, scientists isolated various urinary biomarkers and provided insight into their glycosylation patterns using mass spectrometry.
This information further aided their isolation and subsequent utilisation in conventional and novel diagnostic methods. Studies on European and Chinese patient samples validated the capacity of urinary vesicle profiling to diagnose kidney and cardiovascular disease.
Collectively the results helped determine the cell-specific consequences of diabetes, unveiling new molecular networks involved and novel proteins of diagnostic importance. Considering that environmental and genetic factors influence the rate of disease progression, the international UROSENSE consortium integrated data on specific biomarkers from different regions of the world.
Early intervention can save pre-diabetic people from hospitalisation and progressing to chronic diseases that can incur significant cost to the healthcare system.